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HomeMy WebLinkAbout0007 GLENEAGLE DRIVE - Health Drive Centerville • • • .■■■■■■■■■■■■■■■■■■■■■■■■■■■�i ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■NONE ,I -- No. oq Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes-rl PUBLIC HEALTH DIVISION TOWN OF BARNSTABLE, MASSACHUSETTS u Zppf ration for Misposaf *pstrm Construction 3prrmit Application for a Permit to Construct( ) Repair,(�Cf� Upgrade(' ) Abandon( ) ❑Complete System Individual Com onerits P Y P ,,,,.; Location Address or Lot No. �j�es►Pa� 271;ve Owner's Name, /Address,and Tel.No. ,I Assessor'sMap/Parcel /91 i(o�J �� i Cot y sp 6bio 7111efyr '-�r/✓'4�C� /Z/� ;- w" Installer's Name,Addro� �1.�1o. PV(?a 7,2y Designer's Name,Address,and Tel.No. Type of Building: (s- 3(0 Dwelling No.of Bedrooms r �/ 1 Lot Size S/ �0 / sq.ft. Garbage Grinder( ) Other Type of Building feridcAJNo.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 41YO gpd Design flow provided 44M gpd Plan Date Number of sheets Revision Date Title Size of la Se tic Tank m P /,t - Type of S.A.S. CX%IJ2+h Description of Soil Nature of Repairs or Alterations(Answer when applicable) !jn 'y, a 4 4'Je C°X 660!j an lc®i bot4h•c .-i off Iv `my addd o ) bedecveis- f9eeara r G, o 9V , Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Si Date Q:.2 7 191113 Application Approved by Date _2 Application Disapproved by 14 Date for the following reasons Permit No.� �—Q y�, Date Issued 2 ti.�"�'' � Fee No. D`] W ' THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes-Rm PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS , 2ppfitation for Misposar 6pstemm Construction permit Application for a Permit to Construct( ) Repair Upgrade( ) Abandon( ) ❑Complete System M,Individual Component Location Address or Lot No. , Gk�rus�t i�r;v¢. Owner's Name,Address,and Tel.No. Assessors Ma /Parcel q► t t -7 6le", k CP, ✓,��C `4 p /�G f%O J^1 t Co`d r�� r °D 1 �9 Cif-GSS- Sera Cz`. Installer's Name,Address,anJ Tel.No. �7�, '',1 Designer's Name,Address,and Tel.No. Type of Building: / S/ G \ Dwelling No.of Bedrooms F(�t, r Lot Size 1 sq.ft. Garbage Grinder( ) Other Type of Buildings CI f)r� �,,, No.of Persons Showers( ) Cafeteria,( ) Other Fixtures Design Flow(min.required) 41V O gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title ,,. Size of Septic Tank �o��� t Type of S.A.S. C ���.a-� �Gc" JJle ®•a L rj r Description of Soil Nature of Repairs or Alterations(Answer when applicable) f 11+ C r✓lr e;A,4gt ex t'SAOel TAA V_/ Fd/" AJsIA--CAV./1 oN It/ (A/p r.,44d#;r^a) �1/G7PGOr'1Sr A Ave., f Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. f Signe � y^--�., Date G? ,3i7/. Diw Application Approved by t t1 ., / A l Date Application Disapproved by Date for the following reasonsk Permit No. !0 ' (} L/ 1 Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS `s � - �fl i�^'c Certificate of (Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) (!faired Q ) Upgraded( ) Abandoned( )by kit, r,,, s�l xAe� at_7 G/sn e.4 k Rk t has been constructed in accordance. J with the provisions of Title 5 and the for Disposal System Construction Permit No. )0/X-0/�7 V dated P Installer��( ;�[/' Designer N//4 c� J #bedrooms Fr v/ Approved,design flow 7 f7 gpd The issuance of this permit shall not be construed as a guarantee that the systKm� will func to gas( igned. ` Date J �7 Inspecto?, . - — - --/---_ No. )d 4 l l 1 1 Fee �.!THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS disposal 6pstem Construction 3permit Permission is hereby granted to Construct Je ) Upgrade( ) Abandon( ) System located at 7 o<�s�LD V s We n J ,v and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of this permit Date Approved by �•+ /� , � 1 r �✓��oJ !roc S' � �.P / �;M " a �rP /;Ir M�nr �41 t„ ��I�r r ; e 'LA.NUN ___.T:t ci I- - - 1 I.. 47/ `. I �, : 6:) R4 c Ada AGE t)a4 t2 -�_ _ I ! sr � �god g _ _ R - - _ Lo�N� _ - an 9fi� 41 AM- Ll - 7-6 � f I Vo, gg TOWN OF BARNSTABLE 1 LOCATION 77 C 1_ t&C ja &LZ_ DR.SEWAGE# 2-0(s-_R VILLAGE (f kA1-`9q VjU L ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. )q®d rn e /_(s' e r SEPTIC TANK CAPACITY /OC D 0 0 L ize s LEACHING FACILITY: e � S �t� �c t 3 3�5 NO. OF BEDROOMS OWNER V L.LI VA/V PERMIT DATE: COMPLIANCE DATE: Separation Distance Between e: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY r . 6A G e- 7 !3 3 ,� �3 132.4 A 3 3 � 3 Y _ No. /!/ �gv Fee t THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes application for Disposal 6p$trm ConstCULtioll 3pPrmit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 7 Owner's Name,Address,and Tel.No. Assessor's Map/Parcel ' 4 Ile— W i c---- 5-v 11,f Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. o 5✓ ev � a,�bW oZgUd L5 S(/G`.tl S' G 4#L Type of B ilding: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage GrinderIA ( ) Other Type of Building �j(GS�L{/1�++�,�e No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 77 D gpd Design flow provided �� gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank jigOn Type of S.A.S. S 6vl— 2XLV Z_r' Description of Soil Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has,been issued by this Board of Health. Si ���-- Date /O —/9—I5 Application Approved by , Date Application Disapproved Date for the following reasons Permit No. &1 Date Issued •-6 2� / "�„ x f.a, No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION- TOWN OF BARNSTABLE, MASSACHUSETTS 01pprication for -Misposar 6pstem Construction permit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 7 Vl IC4 q��e /4 Owner's Name,-Address,and Tel.No. Assessor's Map/Parcel 1 ('v/{�'�/i/�� w 6 5i/f'(1✓ ✓1 Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. o �S I�►efz_ s a�6- Boos sv� �� Type of Building: Dwelling No.of Bedrooms 4 Lot Size sq.ft. Garbage Grinder( ) Other Type of Building �&doq—+CKc No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) D gpd Design flow provided y`j gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank l igr?a Type of S.A.S. 5_i�k5 6-o9W_ /7�'(y/�•e/%( m Description of Soil / Nature of Repairs or Alterations(Answer when applicable) &ew Z2- (lx Date last inspected: Agreement: ' The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in k accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. _ Date /O Application Approved by Date /5 Application Disapproved a Date ;` ; for the following.reasons n Permit No. Zo I — 3gC7 Date Issued ------------------------------------------------------------------------------=-------------------------------------------------------- ,� THE COMMONWEALTH OF MASSACHUSETTS_ BARNSTABLE,MA,$ACHUSEI �S r" Certificate of Compliance THIS IS TO CER FAAY,that the On-site Sewage Disposal system Constructed( ) Repaired( �ljpgraded( ) Abandoned( )by 0"1# 61 at ���`Cy)2 aA 2. ]]t2. has been constructed in accordance with the provisions of the for Disposal System Construction Permit No. 0/97 dated 1d�29/Zai7 k Installer-- owfl /S�te.,O_ Designer /�1 S_ 5(_Ikevecl #bedrooms y Approved design flow',�!(} ' gpd The issuance f thi permit shall not be construed as a guarantee that the system wi fii lion as design d. Date ( ( Inspector Zs' d;s' / U✓ I ---- ---- �-`j-------- - --------------- --------------------------- ---------------- -----_---------- ------ ------------------- No. Fee lJ d /6 o� THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Misposal 6pstem Construction i3ermit . Permission is hereby granted to Construct( ) Repair( Upgrade( ) Abandon( ) System located at 7 G�t'�G'Aq�Cr _/_-�w. and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with i Title 5 and the following local provisions or special conditions. ' Provided:Construction must be completed within three years of the date of this permit: Date �(�/�q�7_�j Approved by Town of Barnstable Regulatory Services Thomas F.Geller,Director > MM"KM Public Health Division 039, Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Date: 11-4- �6ewage Permit# Assessor's Map/Parcel 1 -L1Ob Installer&Designer Certification Form Designer: eke --r-zx Installer: ����� -s r�>✓� Address: FL-2 6D-1- 1 Z9 Address: 440 M A I ^3 C G v �c On 'NPY FA5 AEA was issued a permit to install a (date) (installer) septic system at7�1 �Eh��—�� based on a design drawn by (address) " vtn ,t era En dated -�rW "k 2� -2ocs (designer) I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. Stripout (if required) was inspected and the soils were found satisfactory. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system ut in accordance with State & Local Regulations. Plan revision or certi d as-built b d finer to follow. Stripout (if requir ,d inspected and the soils we o � �NOFM40, DAVID °sue J � D. FLAHER7Y,JR. N (Installe s gnature) No. 1211 �4P01STE��O 6 NITAP-1 (Design 's Signatur (Affix Desi 's Stamp Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. gAoffice focros\desipercertitication fonn.doc DEEP OBSERVATION ROLE LOCH Tole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure, to jes,Boulders. Consistency,CIO Gravel jr ZcQmo,� AEEI?`OBSERVATION°IOLE'.LOG X . Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,%Gravel `-144' c siyc� il�ye 76 I*01ORSERVATrO:N HOLE:.LO Hole:# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,%Gravel DEEP OBSERVATION HOLE:LOGTol�.# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stonos,Hottlders. Consistency, Gravel) Flood Insurance Rate May: Above 500 year flood boundary No_ Yes Within 500 year boundary No— Yes 'Within 100 year flood boundary No__—:_-_ Yes —— Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? .Q s If not,what is the depth of naturally occurring pervious material? Certification I certify that on Y 96 (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required trainin pe is n experience described in 310 CMR 15.017. Signatur Date L �� Q:\SEPTIC\PERCFORM.DOC �Wr Town of Barnstable P# . Department of Regulatory Services / Public Health Division Date �I 5 $ rEo 19. � 200 Main Street,Hyannis MA 02601 I' Date Scheduled 7 [yCi Time � r v' Fee Pd. I'tl1J Soil Suitability Assessment for Sew e D'sposal Performed By: t Witnessed By: �` LO:CATI( N EN BI�At,.INh'ORT'�0 Location Address / G �r Owner's Name��L/ ✓� T:�ar4l,f Address l�G v(✓ Assessor's Map/Parcel: �P `�� Engineer's Name NEW CONSTRUCTION REPAIR Telephone# - S ��Jb� Land Use Slopes(%) Surface Stones Distances from: Open Water Body IV14- ft Possible Wet Area eft Drinking Water Well Drainage Way 4114�- ft Property Line ct-) ft Other ZeAt2 zd ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) N a V VJ Parent material(geologic) A, Depth to Bedrock Depth to Groundwater: Standing Water in Hole:_161� Weeping from Pit I320e Estimated Seasonal High Groundwater Z VKT� NATION FOR SEASONA�AIGH TWO���" Method Used: Depth Observed standing in obs.hole: in. Depth to wil mottles: __ in, Depth to weeping from side of obs.hole: ln. Groundwater Adjustment ft. Index Well#---,,--Reading Date: / Index Well level. Adj.factor AdJ C7raundwater bevel l Z PIDRCOLATON:TEST l®lite, l►um.'. :''`: Observatio Hole# Z Time at 9" Z 3L, . Depth of Pere 'b� l0 n Time at 6" Start Pre-soak Time @ Time(9"-6") End Pre-soaks z�i l(7„'� �AA,� Rate Min./inch y �l Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N) Original: Public Health Division Observation Hole Data To Be Completed on Back----------- ***If percolation test is to be conducted within 100' of wetland,you inust first notify the Barnstable Conservation Division at least one (1) week prior to beginning. Town of Barnstable Regulatory Services Thomas F. Geiler, Director Public Health Division Thomas McKean,Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Richard V. Scali,Director FAX: : 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL# 7014 1200 0001 0358 3957 June 3, 2015 Wayne E. Sullivan PO Box 3036 New Bern,NC 28564 ORDER TO COMPLY WITH STATE ENVIROMENTAL CODE, TITLE 5 The septic system located at 7 Gleneagle Drive, Centerville,MA was last inspected on 5/10/2015,by Trevor Kellett, a certified inspector for the State of Massachusetts. The inspection of the septic system showed that the system"Conditionally Passed" under the guidelines of 1995-TITLE 5 (310 CMR 15.00) due to the following: • Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool. You are ordered to repair or replace the septic system with one (1)year from the date you receive this notification.. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. Per order of the Board of Health as . McKean, R.S., C.H.O. Agent of the Board of Health Q:\SEPTIC\Letters Septic Inspection Failures or Future Evl\7 Gleneagle Dr Cent Jun 2015.doc r Parcel Detail x t Apps Bookmarks http.-www,town,barn... Application center Suggested Sites Imported From IE f Parcel lookup L!New Tab Bing }r r]Other bookmarks i�B.tAhSTtilil.E,a, lel ., h1 tSS, rk IV Parcel Info Parcel ID 191.166 Developer cot LOTS 2C&22D Location 7 GLENEAGLE DRIVE Pri Frontage 188 Sec Road OLD STAGE ROAD sec Frontage 160 village CENTERVILLE Fire District CC-O—MM�� Town sewer exists at this address No Road Index 0607 Asbuilt Septic Scan: a Interactive Map w ` 1911661 " t v Owner Info Co- Owner SULLIVAN,WAYNE E Owner _._._. streets P 0 BOX 3036 street2 City NEW BERN state NC Zip 28664 J Country v,land Info Acres 0.36 use Single Fam MDL-01 Zoning RC �Nghbd 0106 Topography'Level Road Paved__ utilities Public Water,Gas,Septic Location �� • Construction Info o T ffud a Year 1983 Roof Gable/Hip 1 E"t_Wood Sh hale r h, �r 11:52AM,,. Start ,, Parcel Detail•Google Ch,. ® V Computer name : HEALTH899JF User name : flvnni Operatinq Svstem : Windows NT (5.1) a tME?I ` L �� Town of Barnstable • antttvsrAetE, v� ��.s639. Regulatory Services Department `�� ArfD MP't� Public Health Division 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 Richard Scali,Director FAX: 508-790-6304 Thomas A.McKean,CHO Feb 6, 2007 Rev. 4/28/15 DEADLINES TO REPAIR FAILED SYSTEMS (Town Code §360-44 and Title V: 310 CMR 15.000) An"x"marked in the ❑ is the failure criteria and associated repair deadline 60 DAY DEADLINE CRITERIA ❑ Discharge or ponding of effluent to the surface of the ground ❑ Pumping more than 4 times during the last year not due to clogged or obstructed pipe. ❑ Backup of sewage into the house due to an overloaded or clogged SAS or cesspool ONE 1 YEAR DEADLINE CRITERIA Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ Any portion of the SAS, cesspool, or privy below high groundwater elevation ❑ Any portion of the cesspool within a Zone 1 to a public well o Any portion of a cesspool within 50 feet of a private water supply well with no acceptable water quality analysis. (This system passes if the water analysis indicates the well is free from pollution). TWO (2) YEAR DEADLINE CRITERIA ❑ Single Cesspool ❑ Any"conditionally passed systems" (broken cover, relocation of a pipe, relocation of a driveway due to H-10 components, etc) ❑ Leaching pit or cesspool with high liquid level, <1.2"below pit(per Town Code §360-9.1) OTHER Repair deadline: Q:\SEPTIC\DEADLINES TO REPAIR FAILED SYSTEMS.doc Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 7 Gleneagle Drive Property Address SULLIVAN,WAYNE E Owner Owner's Name information is required for every Centerville MA 02632 5.10.15 page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When filling out forms A. General Information on the computer, use only the tab 1. Inspector: J� key to move your cursor-do not Trevor Kellett use the return Name of Inspector key. TK Septic Inspections Company Name _ 38 Vacation Lane ' Company Address West Yarmouth MA 02673 L% Cityrrown State Zip Code 508-579-5502 S113744 Telephone Number License Number B. Certification I certify that 1 have personally inspected the sewage,disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: ❑ Passes ❑ Conditionally Passes ® Fails ❑ Needs Further Evaluation by the Local Approving Authority 5.13.15 Inspector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the CEP.The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in th future under the same or different conditions of use. t5ins 3113 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 1 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments '1M 7 Gleneagle Drive Property Address SULLIVAN,WAYNE E Owner Owner's Name information is required for every Centerville MA 02632 5.10.15 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ❑ I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass"section.need to be replaced or repaired.The system,.upon completion of the replacement or repair, as approved by the Board of Health,will pass. Check the box for"yes", "no"or"not determined"(Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available.. ❑ Y ❑ N ❑ ND(Explain below): t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 7 Gleneagle Drive Property Address SULLIVAN,WAYNE E Owner Owner's Name information is required for every Centerville MA 02632 5.10.15 page. City/Town State Zip Code Date of Inspection . B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or' more from a private water supply well". Method used to determine distance:. *" This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"to each of the following for all inspections: Yes No ® ElBackup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ® ❑ Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ® ❑ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than '/2 day flow t5ins•3/13 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 7 Gleneagle Drive Property Address SULLIVAN,WAYNE E Owner Owner's Name information is required for every Centerville MA 02632 5.10.15 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ Z Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ®. Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal-to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ® ❑ The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails.The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes"or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat, or answered"yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins-3/13 Title 5 official,Inspection Form:Subsurface Sewage Disposal System-Page 5 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 7 Gleneagle Drive Property Address SULLIVAN,WAYNE E Owner Owner's Name information is required for every Centerville MA 02632 5.10.15 page. City/Town State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes"or"no"as to each of the following: Yes No ❑ ® Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ . Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? Z ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302_(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 4 Number of bedrooms(actual): 4 DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms). 440 i t5ins•3/13 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 7 Gleneagle Drive Property Address SULLIVAN,WAYNE E Owner Owner's Name information is required for every Centerville MA 02632 5.10.15 page. Cityrrown State Zip Code Date of Inspection D. System Information Description: This system consists of a tank d box and leach pit Number of current residents: 0 Does residence-have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system?(Include laundry system inspection ❑ Yes 0 No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonaluse? ❑ Yes ® No Water meter readings, if available (last 2 years usage(gpd)): Detail: Sump pump? ❑ Yes ® No Last.date 2014 Date ate of occupancy: 201 Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis.of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins•3/13 Title 5 Official Inspection Form:Subsurfam-Sewage Disposal System-Page 7 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 7 Gleneagle Drive Property Address SULLIVAN,WAYNE E Owner Owner's Name information is required for every Centerville MA 02632 5.10.15 page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system El Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no)(if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be obtained from system owner)and a copy of latest inspection of the I/A system by system operator under contract Tight tank.Attach a copy of the DEP approval. ❑ Other(describe): t5in9.3113 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page.8 of 17 Commonwealth of Massachusetts u Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 7 Gleneagle Drive Property Address SULLIVAN,WAYNE E Owner Owner's Name information is required for every Centerville MA 02632 5.10.15 page. City/town State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known)and source of information: 10/20/83 per boh Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 1.3 p g feet Material of construction: ❑ cast iron ®40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): Septic Tank(locate on site plan): Depth below grade: '8 feet Material of construction: ® concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: Years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1500g 6" Sludge depth: t5ins•3113 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 7 Gleneagle Drive Property Address SULLIVAN,WAYNE E Owner Owner's Name information is required for every Centerville MA 02632 5.10.15 page. Cityfrown state Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle 26" Scum thickness 2" 9" Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle 13" How were dimensions determined? measured Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Septic Tank is water tight and structurally sound with liquid at the outlet invert, both tees are intact, this system does not need to be pumped there is high staining and signs of overflow Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle I Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins•3/13 Tille 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,M s 7 Gleneagle Drive Property Address SULLIVAN,WAYNE E Owner Owner's Name information is required for every Centerville . MA 02632 5.10.15 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches,etc.): "Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins-3/13 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 7 Gleneagle Drive Property Address SULLIVAN,WAYNE E Owner Owner's Name information is required for every Centerville MA 02632 5.10.15 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert even Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): D Box is level and water tight, it is down 16"there is one inlet and one outlet, there is a lot of carryover and high stainging in the box and above soil Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No" Alarms in working order: ❑ Yes ❑ No* Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): * If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS)(locate on site plan, excavation not required): If SAS not located, explain why: t5ins•3/13 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 12 of 17 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 7 Gleneagle Drive Property Address SULLIVAN,WAYNE E Owner Owner's Name information is required for every Centerville MA 02632 5.10.15 page. City/Town state Zip Code Date of Inspection D. System Information (cont.) Type' ® leaching pits number: 1 ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/altemative system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): The leaching at the this property consists of a 6x6 pre cast leach pit that is down 25", the inlet pipe is down 31"There is 20 inches of liquid-in the tank and a stain line to the top of the tank and all the way up to grade Cesspools (cesspool must be pumped as part of inspection)(locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 7 Gleneagle Drive Property Address SULLIVAN,WAYNE E Owner Owner's Name information is required for every Centerville MA 02632 5.10.15 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure,level of ponding, condition of vegetation, etc.): Privy(locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5ins•311 3 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 7 Gleneagle Drive Property Address SULLIVAN,WAYNE E Owner Owner's Name information is Centerville MA 02632 5.10.15 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont,) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at-least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately A B O 2 Al) 17 O A2)24 A3)34 B1)33 B2)36 B3)32 t5ins•3/13 Title 5 Official Inspecfion Form:subsurface Sewage Disposal system•Page 15 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,M 7 Gleneagle Drive Property Address SULLIVAN,WAYNE E Owner Owner's Name information is Centerville MA 02632 5.10.15 required for every � page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: 50+ feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ❑ Observed site(abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health-explain: El Checked with local excavators installers- attach documentation ® Accessed USGS database-explain: You must describe how you established the high ground water elevation: USGS Maps show GW at more than 50 feet the bottom of the leaching is at.8.3 feet Before filing this Inspection Report, please see Report Completeness Checklist on next,page. ,,ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage,Disposal System•Page 16 of 17 Commonwealth of Mas$achusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 7 Gleneagle Drive Property Address SULLIVAN,WAYNE E Owner Owner's Name information is required for every Centerville MA 02632 5.10.15 page. Cityrrown State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary:A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems)completed System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file } t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 Town of Barnstable Regulatory Services Thomas F. Geiler,Director Public Health Division Thomas McKean, Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Richard V. Scali,Director FAX: : 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL# 7014 1200 0001 0358 3957 June 3, 2015 Wayne E. Sullivan PO Box 3036 New Bern,NC 28564 ORDER TO COMPLY WITH STATE ENVIROMENTAL CODE,TITLE 5 The septic system located at 7 Gleneagle Drive, Centerville,MA was last inspected on 5/10/2015, by Trevor Kellett, a certified inspector for the State of Massachusetts. The inspection of the septic system showed that the system"Conditionally Passed" under the guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following: • Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool. You are ordered to repair or replace the septic system with one (1)year from the date you receive this notification.. Failure to repair/replace the septic system within the deadline period will result in future Y 6 enforcement action. Per order of the Board of Health 6/ 1_%Vz , as . McKean��R.�S., C.H.O. Agent of the Board of Health Q:\SEPTIC\Letters Septic Inspection Failures or Future Evl\7 Gleneagle Dr Cent Jun 2015.doc Ij FA?— -ej It+4 T LJA,5 �o if-STK-ut--M-fJ U A)�-rl4-6 (9-7 ejo c) :�-7 S- L7 AFFIDAVIT Re: 7 Glenneagle Dr.,Centerville,MA 02632 I,Wayne E. Sullivan,being duly-sworn,state the following under the pains and penalties of perjury: 1. In May 1984,I purchased a four bedroom residence located at 7 Glenneagle Dr., Centerville,MA from Barnstable Holding Company. 2. I still own said property. 3. During the entire period of ownership,the Town of Barnstable has been assessed the property as a four bedroom dwelling. Signed under the pains and penalties tl day of October,2015. r Waynq&lli an COMMONWEALTH OF MASSACHUSETTS Barnstable,ss On this day of October,2015 personally appeared Wayne Sullivan before me,who is known to me,who swore that the,contents of the document are true and correct. f 'No blic JOHN CtARK STEP!{ENSOt� Notary Publle co Notary ;SatCHUSETi3 t'4 cot" ti198iun Expires 20 1 r x Town of Barnstable P# Department of Regulatory Services / S wUM9rABLK : Public Health Division Date NAM t639• 200 Main Street,Hyannis MA 02601 Pm' Date Scheduled ( Time Fee Pd. I �r3 Soil Suitability Assessment for Sew e D'sposal ,y,�Qe � _ Performed By: �� Witnessed By: ��` ^� r`-� LOCATION & EN I AL.. ORI iT O Location Address _,o*G ° Owner's Name C5;� Address Assessor's Map/Parcel: !�,¢P `r/� 0-44 ` �v Engineer's Name NEW CONSTRUCTION REPAIR Telephone# S T_36� Land Use �S l s•1 �R Slopes Surface Stones � t( Distances from: Open Water Body eft Possible Wet Area ft Drinking Water Well Drainage Way A1149- ft Property Line c_ ft Other ZC40 zO ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) o v Parent material(geologic) L Depth to Bedrock Depth to Groundwater: Standing Water in Hole: Weeping from Pit FACa Estimated Seasonal High Groundwater Z DMI MTNATION FOR SEASO�I'A�:YI1G�W A.�E� �'�� Method Used: Depth Observed standing in obs.hole: IV� in. Depth to soil mottles: Depth to weeping from side of obs.hole: itl. Groundwater Adjustment— (_ ft• Index Well#_ Reading Date:�� Index Well level Adj.faCtdP Adj.Groundwater bevel—>l Z PERCOLATION TEST Duce ervationZ Hole Hole# i Time at 9" Depth of Perc �O n Time at 6" L, Start Pre-soak Time @ b� Time(9"-6") r�1 End Pre-soak Rate Min./Incb. Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N) ry/� Original: Public Health Division Observation Hole Data To Be Completed on Back-------- ***If percolation percolation test is to be conducted within 100' of wetland,you Must first notify the Barnstable Conservation Division at least one(1)week prior to beginning. '°rM Q:\SEPTIC\PERCFORM.DOC DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,%Gravel /o S� 7 O •/ �' , ac,•OV iE OBSERVATION HOLE Loy Hole# ?max Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistenc %Gravel p i � — 2v» ct 144 c T 6 DEEP OHSERVATION HOLE LOG Hole Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistenc %Gravel DEEP OPSERVATION HOLE:LOG Hole Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency, Gravel) Flood Insurance Rate Map: / Above 500 year flood boundary No_ Yes .w Within 500 year boundary No— Yes Within 100 year flood boundary No— Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? 6.0 S If not,what is the depth of naturally occurring pervious material?--Allk Certification I certify that on 96 (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required trainin erAis&-anclexperience described in 310 CMR 15.017. t Signatur Date Z �� Q:\SEPTIC\PERCFORM.DOC I v. Fimic .L/ ............ THE COMMONWEALTH OF MASSACHUSETTS BOAR® 9F HEALT a � �� all ¢�� �.�.PY✓✓ ----------.OF...... . .. sLoVsI.L� L� -�-.�-•......................... AppliratioU for Uhipati al Works Cnonstriartion runfit !y� Application is hereby made for a Permit t C nstruct ( or Repair ( ) an Individual Sewage Disposal Syst at: e"�L'n �C ! 3� �.D r / Location- dress or Lot No. . .... . .......................................................•-----••-----•-------•........................•.... .......---........................... ---• -------- ------------ T........----•--•-•-- Own Address Installer Address dType of Building Size Lot----------------------------Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( Garbage Grinder ( ) p`4 Other—Type of Building ....... No. of persons...,,3____________________ Showers ( ) Cafeteria ( ) a Other fixtures -------------------------------- . Design Flow_._...�1._.__._. . gallons per person er day. Total daily flow---. P............................gallons. W /� WSeptic Tank—Liquid c aci �t _gallons Length :._ -__ Width__f!. -'.���..-__. Diameter-_.- Depth.... x Disposal Trench—No... ......__. Width_...M"-_-____._-_ Total Length... Total leaching area...... sq. ft. 3 Seepage Pit No-----/------------ Diameter......./.2..... Depth below inlet... ............... Total leaching area..3.3�_.sq. ft. Other Distribution box ( ) Dosing tanjj ( ) /: '-' Percolation Test Results Performed C-L . ?/�- Date..... ,(�:.___ __-__ _� . as Test Pit No. L.4_2-----minutes per inch Depth of Test Pit.................... De to ground water___________-_ -----.__. (i, Test Pit No. 2.....1,121,------minutes per inch Depth of Test Pit____•--------------- Depth to ground water___________-----__ ___- ------•----.------------•••••••--••- i-- A .Ov 8 Description of So>ld — � ........ 9 ------.----- . -------------------•------------- W - %-------------------------------- ----- U Nature of Repairs or Alterations—Answer when applicable------------------------------------------------------------------------------------------------ - Agreement The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance,has lissu,-rlby the board o al Signe`- 6r ""ne. Dt�Q._... Application Approved By. ...-- •- � --•---------•----------------------------••----•-----•--•------•---- ---�---- '/-:-"-..mac_ / �" Date Application Disapprov `fo he following reasons______________________________________________________________ ---•.............•............ •--........._. ....-•-------------------••--•-•--•--_._......__...----...--•------------•----------------------------------•••----•---•-----•--•--- --------------------------------- ---- ---------- --- - Date PermitNo......................................................... Issued....................................................... Date 5 G >Air, Nod ✓f-__-..._..... FE$..... ............ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...............................-----..-.--.O F..._.....-...........-.......-..........----------------- Appliratiou for Uhipati al Workii Tomitratrtilaat rprutit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ................__.............................................................................. .••-••••-•-----------•••'•--•-•-•-•----•-•...-•-•••--••••--••-••--•-•--••--•-••••-••••-•••--...--- Location-Address or Lot No. .................................................................................................. ...._..___.....-......---.....___..........•...........•-- Owner Address W Installer Address U ,Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) `4 Other—Type T e of Building ____.__.__. No. of ersons____________________________ Showers C4 YP g ----•-•-•-•----•- P ( ) — Cafeteria ( ) Q' Other fixtures ............................... . . W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter---------------- Depth................ Disposal Trench—No_ ____________________ Width.................... Total Length.................... Total leaching area--------------------sq. ft. Seepage Pit No----_-------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by----•---•--------------•--••----•-•-----••--•---'---'•-•--•---•----•----- Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit---------........... Depth to ground water__-___-________________- fi, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ W .................... 0 Description of Soil........................................................................................................................................................................ x v ---------------------------------------------------- '--•--------------------..___... ------------ •---------------------- •------ --•----------- -------------------------------------------------------- W V Nature of Repairs or Alterations—Answer when applicable.______......................................................................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Complian has been issued by the board of health. Signed..-••-----------------'--...--••-•-....----..__...--••---•--•-._...----•----•---•--- ---•--------.-.-----•---•-•---•- Application.Approved By- - =�. . •--•---•------------------------•-------------------•----------------- � Date ` Date Application Disapprov f o he following reasons______________________________________________________ .---•-----------------------------------•'--••--•-•--•--•-----••--••-'---•----••-•---........------....._••----•------------•••-----•-•------•-----•--------------•-•••---...-••-------••--------._.._.. - Date PermitNo..................................................._._•. Issued..... •--�------•-•-•- Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ......................................OF..........................................I...................I...................... Cnrdifiratr ,af TautpliFattrr TLPM IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( or. Repaired ( ) by..... ---- .......................... ••...••--••--••'••....-••••-__..-•- ---••--•-------------------- ,�y ,/� Installer at... ................. ! .r--- + `Y has been installed in accordance with the provisions of TI 5 of T tate Sanitary C a esc • e in the application for Disposal Works Construction Permit �'o.____e ......... dated..... __- __ZC_._ - --.----.---- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A G ARA EE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. �j' j� DATE....4`.----��- -. ....................................... Inspector_...---V.... .. 3-•------------------ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH �j .......................:...................O F............:._......-..-........_......-......_..._-._.......-.........-..-...---... J� ✓ ..... FEE.... C+!.... Ropo l Work, %omit a i]att rrtnit Permission is hereby granted._____ -_ _._ ............................ .................. _-----• •--- to Construct ( . or pair ( ) an ivi Sewage�is sal Syst at No.......... . QLIt L� .. ... , ' ------- ------ -- Street Yoar�d as shown on the application for Disposal Works Construction Permit o............... ed_(f-___..____ ___ ___i_._._.... --------------------------- -------•----- ••---------••-•--...----•--__•- �lZ L�B� alth DATE--•'--•-----------•-•---...----•---•• •-•'•-•-•-------•----------•-----_..... FORM 1255 HOBBS & WARREN, INC., PUBLISHERS . 1 /_07- - i Lt, s , o 7o 7w lij a � � J \ m be -05 149,1 ab 3.9,2 . ., . .97 . -a° 96�° e OF NIL ai• y� y Na14 p / D-n-1 SU F,,s B LEGEND - CERTIFIED. PLOT PLAN EXISTING SPOT ELEVATION Ox0 - --- EXISTING CONTOUR: ...._...: 0 __._ � HOFM�ss FINISHED SPOT ELEVATION � a;t`� y C�/1//ET' V/ L !E� -- _— PINI.SHEO CONTOUR 0 c MORSE I IN APPI�OVED BOARD OF HEALTH ,QNo.1Os51�0 A'90 E•G►StEQ DATE: AGENT ssloriAL��� SCALES / = 4D DATE 1 L �'®GE_ E'NG/NE�'1�IAlG ,CD. IN /_34A#2sT AlNvc�� _ -�.— CLIENTS A CERTIFY THAT ;THE PROPOSED EOI5TEAE ,REGISTERED J08 NO.:' S3 l". BUILDING SHOWN ON THIS PLAN CIVIL. . LAND CONFORMS' TO THE ZONING LAWS ' ENGINEER SUHV:EY R DO BY t ' • �' OF BARNSTABLE , AMASS. 7I2 MAIN STREET.. CH. BY HYANNI,.Sj MASS. 2 _ --. � ; .• 'F SHEET..L.: pF ., �pA E aEG.: LAND, SURVEYOR . 9 •� (e. X-,gam • M 'r,1► tq ^ O M 4 � p O d Ri � P ill � .��„ •���pv'��r�r;::r•;' :r..l�,. ]► A� y JD10!01 -0 vi \ O Q p ? to N %FF�s i llS�a 0 ^ •N,1 •� n o tAA� 11 Dp yyS P 3 2 -i ty � 2 , ( K �ZIt cc Did M � � � R° `ay Mt10 � - �► � ) �' �o mb ^ � � h •� 6 P V` Dv10 k � Irl ri F x to tb P y a No ao � a. •u. ..�...� C 2_ y o - • 0 ... A .. . t ;'0 ti � (� � � � AZ h► C h � � � • y p�. v °� . . vv ° . � � ny �'3y - . t)L o y b z U w IA I vNz� D � �► � tA iA 4 Q LOCATION' L =T t A G'Lzj-j ewc4s- VILLAGE Cfi�T�l��/ 1�� DATE LY n �.... APPLICANT (3 -Rr.sS?' l�l..a r,S� FEE �S ADDIIESS Hy•�P.at-41 S TELEPHONE NO.-1'1 1 -d�.L.�.G'1'y(Non-refundable L WGINEEtt C.DQ DG-�� � OR TELEPHON NO. JI S-1144 DATE SCHEDULED o pplicant' s signature - . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . SOIL LOG SUB-DIVISION NAME 1A DATE /k 0 3 TIME 2 EXPANSION AREA: YES ✓NO _Jo+-i ha �LL-i _ENGINEER TOWN WATER ✓PRIVATE WELL J® 4 4.1%4 -� I BOARD OF HEALTH EXCAVATOR SKETCH: (Street naine, etc. ,dimensions of lot, exact location of test holes and percolation tests, locate wetlands in proximity to test holes ) NOTES: Alois Q 2s A: Q --�-� �- PF,kCOLA'1'IOIJ kA'I'I;: m1l��1_ piR9 GDMPT SAkPO TEST }-TOLE NO: ELEVATION: TEST HOLE NO: I:L.I.:VAT ION: 2 CCs-4,1 � T��� I L 2 3 3 4 4 camp- 6 6 7 7 B . 8 l(�' 9 meolum 9 10 ®'� 14 ` "?4 0 10 11 6avCL' 11 12 12 13 13 14 14 15 15 ' 16 16 SUITABLE FOR SUB-SURFACE LEACHING E FIELD LEACI NG PITS LEACHING TRENCHES UNSUITABLE FOR SUB-SURFACE SEWAGE. REASONS: NOTE : ENGINEERING PLANS MUST SHOW NUMBER ASSIGNED ON PERC TEST APPLICATION ORIGINAL: COMI'LET D IN EN ANVRNED TO BOARD OF III'.A1,T11 CENTERVILLE ' o J LAKE Q WEQUAQUET i LZ 8-333 W PARCEL ID: J 191/017 <N " 3 180.69 o � / �� LOC S N N N / Y GREAT MARSH RD N78.18'41 ROUTE 28 00 \ P/>RCEL ;ID: / LOCUS MAP' �yY 191/166 / I AREA-15,864f S.F. / / LOCUS INFORMATION PLAN REF: 382/74 TITLE REF: 4102/177 4 / Q PARCEL ID: MAP 191 PAR. 166 \ PRPGE / o f ZONING: E: h ` Ck I FLOOD ZONES "X" G COMMUNITY PANEL: 25001C0561 J DATED:p7/16/14 L�Lj SEPTIC SYSTEM SAVE \\ N� 20"OAK REPAIR PLAN 0 \ it I / LOCATED AT: DTM1 10.0'. / I #7 - - ,. / -7 GLEN EAGLE 4 BEDROOM DWELLING DRIVE \ ® ' " " \ 20. TCF,54.68 / i CEN TER VI LLE, MA. n CD PREPARED FOR ' SAVEDTH \\ SAVE 52 1 A OG NK ° 1 �4/ �/ WAYN E E. SULLIVAN HOLLYl L4 0Ln 1 \ 0 / ° M=54.22 W 5 / AUGUST 31, 2015 \ SAVE t OF A �ygAOF c O \ PINE �'-(ABANDON / ��P 4Ss�cy o'`'� ®f�4'® 13.0'. L _ �' EXIST. ,{ W / / o. EDWARD s Q \ C> ST H \ CB/DH \ \ // o. 89 E SJQ SANITARY 52� /, L LA .00 \\UPOLE i 27DMH � MH °� :E. A. S. o INC. CBAS \\ GRAPHIC SCALE P.O. BOX 1729 1 \\ 20 of '° 20 40 80 SANDWICH, MA. 02563 mom ( ®1 ( IN FEET ) BUS:(508)888-3619 CELL:(508)527-3600 CBAS� 1 inch 20 ft. SHEET 1 OF 2 J 1769 TOP OF FOUNDATION 2" LAYER OF ELEV.= 54.68' 4" SCHEDULE 40 P.V.C. PROFILE OF " _ „ MIN. PITCH 1/8" PER FOOT SEWAGE DISPOSAL SYSTEM DOUBLE WASHED STONE 10-MINIMUM-� (NOT TO SCALE) OR FILTER FABRIC EL= 52.7' EL=52.6' EL= 52.5 EL= 52.5 ::aa;,;. :<11.. .. AX.6" M r: MAX.,;•..,•.. ..,,,.•,.,,,• ..;,;::i�.•,,,,,,,,;;;;;;;.... .,.,.....,.,..,.,,.,,.....•................. ADD ADD INVERT RISER ISER & CONC. EL=48.50 COVER COVER RISER & '�lv� 3.0 10' S=o.oS EL=51.8o COVER LEVEL, EXISTING PIPE zzi 10' s= .1s FOR 2' EL= 49.5 EXIST. EXIST. FLOW LINE "r 5=.01 INVERT INVERT C� 0 0 ° 0 °� ° °° INVERT INVERT 110" 14" INVERT ° o ° 36" EL=51.18' EL=50.70' MIN. EL=50.45 EL=48.82' 6" SUMP EL=48.65' 24" Q 00 ° 0 (� 0 o ADD 4 GAS 6" BASE OF MECHANICALLY 0 o 0 o� BAFFLE COMPACIEO SANG ° 0L=46.5 PROP. D133 4 0' 8 5' 4.0' DISTRIBTION BOX (HU 20) (TYP.) EXISTING WITH "T" 3/4" TO 1-�1/2" 33.5 O z 1 ,000 GALLON TANK Of DOUBLE WASHED STONE 3-500 GAL. (H-20) DRY WELLS (5.0' X 8'-6" X 3'-0") (TO REMAIN) SOIL ABSORBTION (TRENCH FORMATION) o s SYSTEM (S.A.S.) 13' X 33.5' (o I CERTIFY THAT I AM CURRENTLY APPROVED BY THE bEPARTMENT OF BOTTOM OF DTH2 EL=40.1 GENERAL NOTES ENVIRONMENTAL PROTECTION PURSUANT TO 310 CMR 15.017 TO CONDUCT SOIL EVALUATIONS AND THAT THE ABOVE ANALYSIS HAS BEEN PERFORMED 1. ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO D.E.P. BY ME CONSISTENT WITH THE REQUIRED TRAINING, EXPERTISE, AND EXPERIENCE TITLE 5 AND THE TOWN OF BARNSTABLE RULES AND REGULATIONS DESCRIBED IN 310 CMR 15.017. 1 FURTHER CERTIFY Tl�AT THE RESULTS OF MY DESIGN DATA: FOR SUBSURFACE DISPOSAL OF SEWERAGE. SOIL EVALUATION, AS INDICATED ON THE ATTACHED :'OIL EVALUATION FORM, 2. ALL ACCESS PORTS OVER TANK TEES SHALL BE ARE ACCURATE ND IN ACCORDANCE WITH 310 CMR 15.100 THROUGH 15.107. ACCESSIBLE WITHIN 6" OF FINISH GRADE, WITH ANY REMAINING NUMBER OF BEDROOMS...... 4-- ACCESS PORTS BROUGHT TO WITHIN 6" OF FINISH GRADE. 3. ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE GARBAGE DISPOSAL................. NO CAPABLE OF WITHSTANDING H-10 LOADING UNLESS THEY ARE EDWARD A. 19T&X CERTIFIE SOIL EVALUATOR TOTAL ESTIMATED FLOW UNDER OR.WITHIN 10' OF DRIVES OR PARKING AREAS THEN THEY MEN MUST WITHSTAND H-20 LOADING. (110 GAL./BR:/DAY X 4 BR.) __440 4. THE EXCAVATION CONTRACTOR SHALL VERIFY THE LOCATION TEST PIT RESULTS: 440GPD X 200% = 880 GAL OF ALL UTILITIES PRIOR TO ANY EXCAVATION. USE EXIST. 1000 GAL. SEPTIC TANK 5. ANY MASONRY UNITS USED TO BRING COVERS TO GRADE OR WITHIN 6" OF GRADE SHALL BE MORTARED IN PLACE. SOIL TEST DATE: JULY 29, 2015 INSTALL: 3-500 GAL. DRY WELLS (W/4' CRUSHED STONE 6. FINISH GRADE SHALL HAVE A MINIMUM OF 2% GRADE OVER THE S.A.S. AND DISTRIBUTION BOX. B.O.H. AGENT: DAVE STANTON, R.S. ON THE SIDES, 4' ON THE ENDS) 7. SEPTIC TANK SANITARY TEES SHALL BE CONSTRUCTED OF SOIL EVALUATOR: EDWARD A. STONE SCHEDULE 40 PVC AND SHALL EXTEND A MINIMUM OF 6" ABOVE THE FLOW LINE AND SHALL BE ON THE CENTERLINE AND BACKHOE: RODNEY FISHER MIKE SOIL CLASSIFICATION................ LOCATED DIRECTLY UNDER THE CLEANOUT MANHOLES. DESIGN PERCOLATION RATE..... N--/lN. 8. THE INLET PIPE INVERT ELEVATION SHALL BE NO LESS THAN 2 INCHES NOR MORE THAN 3 INCHES ABOVE THE INVERT DTH#1 EL.= 52.6 t EFFLUENT LOADING RATE.........__74-_- ELEVATION OF THE OUTLET PIPE. REQUIRED LEACHING CAPACITY.....4_40 GAL/DAY 9. THE SEPTIC TANK SHALL HAVE A MINIMUM COVER OF 9 INCHES. ELEV. DEPTH (IN.) HORIZON TEXTURE COLOR MOTTLING OTHER LEACHING CAPACITY PROVIDED.....459 GAl./DAY 10. THE OUTLET SANITARY TEE SHALL BE EQUIPPED WITH A GAS 52.1 0"-6" A/E LOAMY SAND 10YR5/1 N/A BAFFLE, 4 INCHES IN DIAMETER AND CONTRUCTED OF 4" PVC. SIDEWALL:(13.0' + 33.5')x2x(2 SIDES)(.74)= 137 GAL/DAY 11. ALL PIPES SHALL BE SCHEDULE 40 PVC SEWER PIPE AND 50.6 6"-24" B LOAMY SAND 7.5YRI5/6 N/A ---- , FIRST TWO FEET OUT OF THE DISTRIBUTION BOX SHALL 40.6 24"-144" C MEDSAND 10YR7/6 N/A --- BOTTOM: (13 X 33.5 )(.74)= 322 GAL/DAY BE LEVEL. . DAY 12. CHANGES OR REVISIONS TO SEPTIC DESIGN REQUIRE NOTIFICATION TOTAL= 459 GAL/ TO EAS SURVEY INC. FOR B.O.H. AND DESIGN ENGINEERS REVIEW NO GROUNDWATER/NO MOTTLES ENCOUNTERED AND APPROVAL. 459 GPD PROVIDED - 440 GPD REQUIRED = 19 GPD RESERVE 13. PROPOSED SEPTIC SYSTEM IS NOT WITHIN STATE APPROVED ZONE II DTH#2 EL.= 52.1 (PERC<2 MPI)' BOTTOM © 66" "°F CONSTRUCTION NOTES: � " OF M�- '� SEPTIC SYSTEM DETAIL PAGE 1. CONTRACTORS / INSTALLERS SHALL VERIFY GRADES AND ELEV. DEPTH (IN.) HORIZON TEXTURE COLOR MOTTLING OTHER ti DAVID o� EDWARD s #7 GLENEAGLE DRIVE ELEVATIONS AND SITE CONDITIONS PRIOR TO COMMENCING 51.5 0"-8" A/E LOAMY SAND 10YR5/1 N/A ----- i A. E J WORK ON THE SITE. CENTERVILLE, MA. 49.6 8"-30" B LOAMY SAND 7.5YR5/6 N/A S 0 12 2. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE _ -a No 89 O AUGUST 31, 2015 WITH DEEDED OR ZONING REGULATIONS. OWNER / APPLICANT 40.1 30'-144" C MED.SAND 1OYR7,/6. N/A IS TO OBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY. 3. ALL SYSTEM COMPONENTS SHALL BE MARKED WITH MAGNETIC MARKING NO GROUNDWATER/NO MOTTLES ENCOUNTERED AL LAND gN9T R%�. / SHEET 2 OF 2 J# 1769 TAPE OR A COMPARABLE MEANS. r r t CENTERVI'LLE o_ 0 :LAKE Q WEQUAQUET PARCEL ID: s w J 191/017 o / 'P LO S 1 g0.69 o Co / .. N N / / 2 �o N GREAT MARSH RD TE 28 04 PARCEL :ID: / LOCUS MAP' 00 \ 191/1,66 1 / AREA=15,864f S.F. l _ „/ LOCUS INFORMATION PLAN REF: 382/74 TITLE REF: 4102/177 R PARCEL ID: MAP :191 PAR. 166 ZONING: 7RC' GE FLOOD ZONE: ",X" �FC COMMUNITY PANEL: GPRP \, I / r25001CO561J DATED:07/16'/14 \\ SEPTIC SYSTEM \ � SAVE V \ N 20"OAK I II -� Q REPAIR PLAN 0 a. \ � °TM1 10.0' � � w #7 ;e LOCATED AT: Q , Z / 7 GLENEAGLE DRIVE \ 52.6 4 BEDROOM :DWELLING / \ l 20.7 TCF=54.68 / w CEN TER VI LLE, MA. -�/ PREPARED FOR SAVE \\\ 5zSAVE ' '0NK ° WAYN E E. SULLIVAN HOLLY w M=54.22 N/ n�` /� AUGUST 31, 2015 \ SAVE OF O \ PINE �" / I ZN OF Ngssgc 13.0 L ( `-�(EXIST.ABANDON \ / oi� EDWARD yes o D Q �� a 1, I L.P. W / / A 4\ \ Zp. / Q ST H F y CB/DH _ \ \ // 0. 89 e� 9�c/STE �O SANITARN � 2, 0 ✓'\ UPOLE 0 DMH DMH\ , (,o �°� ��� - E. A. S. \� I CBAS \\ GRAPHIC SCALE suRVEY, INC. \ I P.O. BOX 1729 20 o 'f 10 20 40 `so SANDWICH,, 'MA. 02563: _y (®1 ( IN FELT ) BUS:(.508)888-3619 CELL:(508)'527-3600 CBAS\- / 1 inch = 20 ft. t SHEET 1 OF 2 J 1769 TOP OF FOUNDATION sf; ELEV.= 54.68' 4" SCHEDULE 40 P.V.C. PROFILE OF 2" LAYER OF MIN. PITCH 1/8" PER Fool , SEWAGE DISPOSAL SYSTEM DOUBLE"WASH "ED STONE 10' MINIMUM--►� (NOT TO SCALE) OR FILTER FABRIC EL= 52.7' EL=52.6' .....,.. EL= 52.5 EL= 52.5 6" MAX.' .,...,...,, :: ;;::�1.., 6" MAX. ADD ADD ..... .. % %% :�.. RISER ISER & CONC. INVERT COVER COVER RISER & EL=48.50 '�1� 3.0' 10' S=0.05 EL=51.80 LEVEL C.) EXISTING PIPE 10' S= .16 COVER FOR ' EXIST. EXIST. FLOW LINE =01 EL= 49.5 INVERT INVERT 110" 14„ INVERT INVERT INVERT 0 0 ° 0 t ° °° EL=51.18' EL=50.70' MIN. EL=50.45 EL=48.82' 6" SUMP EL=48.65' �� ° °° °° °° ° 36" 4, Acns 24 0 � ° � DOD 0 C� � BAFFLE 6" BASE OF MECHANICALLY ° o o °Q� COMPACTED SAND ° ° L=46.5 PROP. DB3 DISTRIBUTION 4'0 8.5' L4.0' BOX (H-20) { (TYP.) EXISTING WITH "T" 3/4" To 1'i-/2" 33.5' 'o z 1 ,000 GALLON TANK DOUBLE WASHED STONE 3-500 GAL. (H-20) DRY WELLS (5.0' X 8'-6" X 3'-0") w (TO REMAIN) SOIL ABSORBTION (TRENCH FORMATION) o SYSTEM (S.A.S.) 13' X 33.5' GENERAL NOTES I CERTIFY THAT I AM CURRENTLY APPROVED BY THE 'DEPARTMENT OF BOTTOM OF DTH 2 EL=40.1 ENVIRONMENTAL PROTECTION PURSUANT TO 310 CMR ,15.017 TO CONDUCT SOIL EVALUATIONS AND THAT THE ABOVE ANALYSIS HAS BEEN PERFORMED 1. ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO D.E.P. BY ME CONSISTENT WITH THE REQUIRED TRAINING, EXPERTISE, AND EXPERIENCE TITLE 5 AND THE TOWN OF BARNSTABLE RULES AND REGULATIONS DESCRIBED IN 310 CMR 15.017. 1 FURTHER CERTIFY TWAT THE RESULTS OF MY FOR SUBSURFACE DISPOSAL OF SEWERAGE. SOIL EVALUATION, AS INDICATED ON THE ATTACHED SOIL EVALUATION FORM, DESIGN DATA: 2. ALL ACCESS PORTS OVER TANK TEES SHALL BE ARE ACCURATE ND IN ACCORDANCE WITH 310 CMR 15.100 THROUGH 15.107. ACCESSIBLE WITHIN 6' OF FINISH GRADE, WITH ANY REMAINING ACCESS PORTS BROUGHT TO WITHIN 6" OF FINISH GRADE. NUMBER OF BEDROOMS......... 4 3. ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE GARBAGE DISPOSAL.................__ NO CAPABLE OF WITHSTANDING H-10 LOADING UNLESS THEY ARE EDWARD A. TO C RTIFIE SOIL EVALUATOR UNDER OR WITHIN 10' OF DRIVES OR PARKING AREAS THEN THEY TOTAL ESTIMATED FLOW MUST WITHSTAND H-20 LOADING. (110 GAL./BR:/DAY X 4 BR.) __44_0___ 4. THE EXCAVATION CONTRACTOR SHALL VERIFY THE LOCATION OF ALL UTILITIES PRIOR TO ANY EXCAVATION. TEST PIT RESULTS: 440GPD X 200% = 880 GAL 5. ANY MASONRY UNITS USED TO BRING COVERS TO GRADE USE EXIST. 1000 GAL. SEPTIC TANK OR WITHIN 6" OF GRADE SHALL BE MORTARED IN PLACE. SOIL TEST DATE: JULY 29, 2015 INSTALL: 3-500 GAL. DRY WELLS W 4' CRUSHED STONE 6. FINISH GRADE SHALL HAVE A MINIMUM OF 2% GRADE ( / OVER THE S.A.S. AND DISTRIBUTION BOX. B.O.H. AGENT: DAVE STANTON, R.S. ON THE SIDES, 4' ON THE ENDS) 7. SEPTIC TANK SANITARY TEES SHALL BE CONSTRUCTED OF SOIL EVALUATOR: EDWARD A. STONE SCHEDULE 40 PVC AND SHALL EXTEND A MINIMUM OF 6" ABOVE THE FLOW LINE AND SHALL BE ON THE CENTERLINE AND BACKHOE: RODNEY FISHER MIKE 1 LOCATED DIRECTLY UNDER THE CLEANOUT MANHOLES. SOIL CLASSIFICATION.................__l____ 8. THE INLET PIPE INVERT ELEVATION SHALL BE NO LESS THAN DESIGN PERCOLATION RATE..... <2J,&ti,/iN 2 INCHES NOR MORE THAN 3 INCHES ABOVE THE INVERT ELEVATION OF THE OUTLET PIPE. DTH#1 EL.= 52.6 EFFLUENT LOADING RATE..........__74___ 9. THE SEPTIC TANK SHALL HAVE A MINIMUM COVER OF 9 INCHES. IN.ELEV. DEPTH (IN.) HORIZON TEXTURE COLOR L, MOTTLING OTHER REQUIRED LEACHING CAPACITY.....440LZD GAAY 10. THE OUTLET SANITARY TEE SHALL BE EQUIPPED WITH A GAS. LEACHING CAPACITY PROVIDED.....459 GAUDAY BAFFLE, 4 INCHES IN DIAMETER AND CONTRUCTED OF 4" PVC. 52.1 0"-6" A/E LOAMY SAND 1OYR5/1 N/A _____ 11. ALL PIPES SHALL BE SCHEDULE 40 PVC SEWER PIPE AND 50.6 6"-24" B LOAMY SAND 7.5YR5/6 N/A ---- SIDEWALL: (13.0' + 33.5')X2X(2 SIDES)(.74)= 137 GAL/DAY FIRST I S T 0 FEET OUT OF THE DISTRIBUTION BOX SHALL 40.6 24"-144" C MED.SAND 10YR7/6 N/A --- BOTTOM: (13' X 33.5')(.74)= 322 GAL/DAY 12. CHANGES OR REVISIONS TO SEPTIC DESIGN REQUIRE NOTIFICATION TOTAL= 459 GAL DAY TO EAS SURVEY INC. FOR B.O.H. AND DESIGN ENGINEERS REVIEW NO GROUNDWATER/NO MOTTLES ENCOUNTERED / AND APPROVAL. 459 GPD PROVIDED - 440 GPD REQUIRED = 19 GPD RESERVE 13. PROPOSED SEPTIC SYSTEM IS NOT WITHIN STATE APPROVED ZONE II CONSTRUCTION NOTES: DTH#2 EL.= 52.1 (PERC<2 MPI) BOTTOM © 66 �j� of MASS � ,�14OF„ . DEPTH IN. HORIZON TEXTURE COLOR MOTTLING OTHER ��" 'Oy DAVID SEPTIC SYSTEM DETAIL PAGE ELEV 1. CONTRACTORS / INSTALLERS SHALL VERIFY GRADES AND ( � EDWARD a�, #7 GLENEAGLE DRIVE ELEVATIONS AND SITE CONDITIONS PRIOR TO COMMENCING 51.5 0"-8" A/E LOAMY SAND 10YR5'/1 N/A ----- ? A �, WORK ON THE SITE. o E J CENTERVILLE, MA. 2. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE 49.6 8"-30" B LOAMY SAND 7.5YR5/6 N/A ---- S 0 12 WITH DEEDED OR ZONING REGULATIONS. OWNER / APPLICANT 40.1 30"-144" C MED.SAND 1OYR7,�/6 N/A --- No 89 AUGUST 31, 2015 IS TO OBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY. ���STER� 3. ALL SYSTEM COMPONENTS SHALL BE MARKED WITH MAGNETIC MARKING NO GROUNDWATER/NO MOTTLES ENCOUNTERED at allo i TAPE OR A COMPARABLE MEANS. � � �, SHEET 2 OF 2 J# 1769